With the already enormous number of caregivers in the United States growing, the need for varied and community-specific respite programs is becoming ever more urgent. At its best, respite for caregivers can restore hope, keep care recipients out of overtaxed care facilities, and knit communities together. Exhale, as a model, allows philanthropic resources at any level to create and support respite that works for the caregivers and the provider organizations in a particular place at a particular time. 

The following five components of the Exhale model, when used together, allow a community to create solutions that will work for them. What works in one place may not be best suited to another, and allowing community direction and organizational collaboration ensures that each model is tailored to the resources and needs of a given people and place. 

• Training and capacity building in problem solving, program management, evaluation, marketing, advocacy, and other technical support. 
• Grant funding of innovative, caregiver-informed, respite projects. 
• Ongoing support toward effective implementation, evaluation, sustainability, and expansion of respite projects through learning communities for grantee partners. 
• Expanded knowledge about respite and caregivers. 
• Collaboration across and within projects. 

Exhale is also unique in expanding the definition of respite beyond the traditional concepts of respite that center around the care recipient. A focus on the caregiver allows the respite services to diversify to what caregivers identify as their most pressing needs. Exhale has developed five respite archetypes that help to explain the ways in which caregivers can receive the breaks they need: 

1. Caregiver Free Time – Caregivers use available time as they wish while their loved one is in someone else’s care. 
2. Structured Caregiver Offerings – Caregivers attend a program designed for them and choose how their loved one will be cared for during that time.  
3. Shared Experience – Caregivers and their loved ones attend a program, event, or activity designed for both. 
4. Technology Solutions – Hardware and software are deployed to address issues that are keeping caregivers from getting a break, creating undue stress, or restricting their activities.  
5. Non-Tech Solutions – Resources are deployed to address issues that are keeping caregivers from getting a break, creating undue stress, or restricting their activities.  

Exhale has worked with the New York Academy of Medicine’s Center for Evaluation and Applied Research to conduct developmental and network evaluations of all funded programs and the broader initiatives. With both qualitative and quantitative research, the evaluation team has been able to collect a wealth of data on the wide variety of programs already underway including through the use of intensity measures like the Caregiver Intensity Index (CII), participant and organizational interviews, attendance metrics, etc. 

Exhale’s impact on caregivers is layered. Individual programs are designed to achieve different impacts on different numbers of caregivers as outlined by the archetypes. When caregivers have free time while their loved one is in someone else’s care, these programs tend to serve smaller numbers of people, usually 10-20 at a time, and the same people tend to be repeat, or long-term services. Other types of respite provisions can reach hundreds of caregivers, depending upon their structure, repetition, and the needs they are designed to serve. 

When caregivers are unable to get a break, they often experience increasing levels of stress, feelings of isolation, deteriorating coping skills, compromised health, reduced or lost employment, social isolation and more. For the care recipient it can mean worsened health outcomes, emergency room visits, placement in long-term care facilities, homelessness, or abuse. Some specific resources related to the consequences of a lack of respite include: 

• Respite Services: A Critical Support for Family Caregivers   
• Respite Resources for Caregivers 
• 14 Life-Changing Tips to Relieve Caregiver Stress   

Funders ready to learn more can review the Exhale website or reach out to The Philanthropic Initiative (TPI) at info@tpi.org for an initial exploratory conversation.